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The Connection Between Chronic Health Conditions and Shingles

Last updated: June 2022

The two most common risk factors for developing shingles are older age and having a chronic health condition that impacts your immune system. Shingles is a common viral infection that is caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. After you have chickenpox, VZV stays dormant (inactive) in your body. If it is reactivated by your immune system, it causes shingles.1-3

Why does having a chronic health condition put you more at risk?

Having a chronic health condition may weaken your immune system or impact your immune system’s ability to work normally. A weakened immune system lowers your ability to fight certain illnesses, infections, and viruses. So, it puts you at higher risk for shingles.1,2

The risks of getting shingles, having a more severe case of it, and having complications with it are all higher in immunocompromised people with:1,3

  • Bone marrow or stem cell transplants
  • Cancer
  • HIV/AIDS
  • Organ transplants
  • Auto-immune conditions or conditions that cause chronic inflammation
  • The need to take immune-suppressing drugs. People who have a condition such as rheumatoid arthritis or who need to prevent rejection after an organ transplant often take these drugs.

Complications of shingles

In addition to being at an increased risk for shingles, people with chronic health conditions that impact their immune system are at greater risk for shingles-related complications.3

Beyond the initial painful rash, shingles complications can include:3

  • Prolonged nerve pain (postherpetic neuralgia, or PHN). PHN can cause burning, shooting pain, numbness and tingling, sensitivity, and itching in the area where the shingles rash appeared. PHN lasts 3 months or longer after the blisters have healed. This is the most common complication of shingles. About 1 in 10 people who get shingles will have PHN.
  • Vision problems or blindness. Inflammation and damage to the retina can develop if the shingles rash is around the skin near the eye. This is a serious complication and should be treated as soon as possible with antiviral medicines.
  • Skin infections. If bacteria enter the sores of the rash, they can get infected. Keep the sores clean, dry, and covered to reduce the chances of infection.
  • Ear inflammation. This inflammation can lead to hearing problems, balance issues, and temporary drooping on one side of the face. It can be treated with antiviral medicines and steroids.

Early treatment with antiviral medicine is critical to lower the risk of complications.3

Getting vaccinated to protect yourself

Shingles can be prevented with the Shingrix vaccine. Shingrix helps defend the immune system against the reactivation of VZV. It is over 90 percent effective in preventing shingles. The shingles vaccine also helps shorten the length and severity of shingles, and it lowers the risk for longer-term complications like PHN.1-3

Shingrix is safe for use in people with autoimmune and other system problems. According to the Centers for Disease Control and Prevention (CDC), people age 19 and older who have a weakened immune system should get the Shingrix vaccine to protect themselves from shingles.2

Talk to your doctor about timing your vaccination for when your immune response is likely to be at its strongest, if possible. For example, if you are preparing for cancer treatment or an organ transplant, it may be best to get the shingles vaccine beforehand.2

If you have an immune system problem or an autoimmune condition and have not had the shingles vaccine, talk to your doctor about getting vaccinated.

Other ways to minimize your risk

There are ways to help boost your overall health and lower your risk of getting shingles. Ways to stay healthy include:4

  • Stay up to date on all vaccinations, including the shingles vaccine
  • Do not smoke
  • Eat a healthy diet rich in fruits and vegetables
  • Exercise regularly
  • Stay hydrated
  • Limit alcohol use
  • Get plenty of sleep
  • Try to reduce stress

What to do if you get shingles

Getting vaccinated greatly reduces your chance of getting shingles, but there is still a slight risk of VZV reactivation. If you have any symptoms of what you believe to be shingles, see your doctor as soon as possible. Early treatment with antiviral medicines can help the rash heal more quickly and lower your risk of complications.2,3

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